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INTRODUCTORY LECTURE 

OF THE 

I 'Ni : 1 1 l'.\J)liEl> AND NINTH SESSION 

OF Til E 

MEDICAL DEPARTMENT 

OF THE 

WW IRSIT1 OF PENNSYLVANIA, 

i l I I\ I III II IN THE 

MEDICAL HALL, 

of /<>/{/ /; //. iS74. 

A L P B E I) STILLfi, M.D., 

.. .» i - i ,,.» 1HEOHV AMi PRACTICE OF MEDICINE, ETC. 



PUBLISHED BY THE CLASS. 



0OLL1K , 



Pfl I LA feBLPBtAs 
im; INTER, 708 JAYNB 
1874. 



STREET. 



coim: ESPQNDENCE. 



At a inn-! in-' ..!' I lie Millie • I < 'I i l>f till I n \ It) • •( I'-mi \!i;nn . hfl- 1 OoCobdf 
16, I'VI Heir thl PltTBOittof ie.|ii.*ling a e..|. y <>! Pnd Allied Suite- I n< roduet >r\ 

A. I. in Mi A w. JUotley, of Pt»Ua<i<ilphia, wiif oalle(l to tfet Chair, And Mr M . 
g i|. mi i , itnQ, mi ippolnted Sterol <i y 

<>n mot fit It was 

Ut$olv*d t ' i * 1 1 : 1 1 ii eommilU ulitfng of* r*nre«entative from •Mill Mate and 

eonntrj be appointed to oatry out lb* Intention ofthi Cla miNnt ivninvivania 
i.r entitled t.. rtprmntatlvi for evtrj ten student 

\'\\ \ BRSfTI "i Pi \ss\ / \ im \. Mi nit vi I ' r i' \ ii i m i si, 

pin h.d. -i, .in , fotobai ft, 1874 

DkarSir: The undersigned werr Appointed it peeial oomtnltie* *»i • n tine of 

the Medical Class bold on the Iftth unt . t.. «olicil ticopj for pubilmttlon ol your 
rthle ii ii d id "i | ii I* n i Introductory Address, dflivered In tbonofl Medical 1 1 *« 1 1 . October 
12. Ittti A compliance witb the roqaeot will be regarded r manifestation of 

kindness Inwards us. A W. RaKMLKT* I'lnl.nl. |,,|iiji. 

Th I'. Li \ i.%< i.. Pforugd mnta. 

J II M. I'VMI I . I -Ml 

Ai.initi M 01 it it v . <'<mii In-nt 

<; r>v T. i*i a h a i vt-i.u.A, Brazil. 

A. Mason Evans, West Virginia* 

Prof Alfkkd Stilll, M.I>. 

3000 Spruce Street, October 20, 1*71. 
tiKSTi.HMKX : I have tnuch pleasure in complying with the request contained in 
your communication of the I9tn lost. Hoping that the good which the Ad Irew eras 
intended to effect innv he mm- perfectly seen red in this manner than hy the tran- 
sient impression of its oral delivery, 

With many th ink- (or the kind terms in which your request was made, 

I remain, rorj faithfully, 

Ymir fl iend, 

\i.Mti:i» stii.i i;. 

Messrs. A W. Ranslev, TftBOOORB j? Livknoomh, J II MiI>vmii, Air.iur M. 

Curry, G. ok T. Piza b Almeida, a Masob Bvaj 



( 'n\|\;i TTRR OR 
Charles J. GARB, Pennsylvania. 
Fowin B. Bkktolet, M 
J as. Wii.kks O'Neal, 
Mom kx J. Kmnk, 44 
Gkhuijk R Young, 44 
Bkn.j. F. Baku. 
Joseph P. Nevis, 44 
(i BoO vr Dr. a n. 

Alfkeo F. B. Geubkhh n, Pennsylvania. 

Abb \m s. Bbo baker, V 

II. Clay Brown, 44 
C. Ammon Wish art, 

OBARLBS K La on, 44 

Fi-.knanue/. Tom>. 44 

Thou ^ F. Fimh.fv, 11 

Hersf.i ||. MuiHF.usiiAt r.il, 44 

TllEoOORK F. Lit KNGoOO, 44 
Jl'.l l ERsoN 1> ClIHISTMAN, 44 

Willi in R Bitlbr, 

Wm. McD BlAstiHi Alabama 

jABBfl II C&ARDLBB, Barhadoes. 
< J . Dl T PjRA i A i. v i: i o A. Bra/il. 

a lbbb i Mi itai Dorr b, Culifornia. 

JORL Q m in. Rhode Island. 

Alkert M. 0i bri . OonneotlbRt. 

M B. SBIP, ^rrrt.rry. 



VVVA.U ATION. 

li w m.i. A It \ BIRRB, Ottbl 

Brwarr P« i'iivcmvn. M oaiaobRaaUB* 

Smith OoOBRR, helaw.ire. 
Kinv auii F V \ i i s, | Ulnol 

T:n»M iji \v hfooBRiii no, tndUna 

J'-iis A. hi. Ai!M<>\o, [oWfl 

At. i:\amm u B. BtooPSi l\ 'lit iK-ky. 

CbarlBD B. Ooi OBBOROI Oil, Maryland. 

David Ch:itN a, MfXiQO. 

Simon QUBOORI w Aita, 

Joseph II . MoDaBII I I •• x:i-. 

Geo. A. CM' Im — ii. PriOOf I'Mward's Is. 

Geor*;k Jons- ClQRAB, Sc. .i land. 

ROBBB i H. Ki t i'. "hi,,. 

A. Mason K\ w-. W. -i Virginia. 

Fkank a. Wvki'ii . South Oarolina. 

Aicrnt u K. M v< DOKALO, New Jersey. 
Thomas H. A HOB] w •. floorgill 
John G. Oambbbll, Nfova Sootio, 

0BORGB H <'"in BR, N' w i'.i nnswick. 

Charles K. M< Kklvi v, N««w York 

Pauis I). GlLTRBRj Oregon. 

Sam e B Both, Jr.. Tennessee. 

James Hay, Virginia. 

At 01 sn s H SSOLLICOPI |B| X. Car<dina. 

A. W. kans l.l'^ , Carman. 



['NTRQMGTOtS LECTURE. 



I 1 1 i i i \i I . 

1 1 li A ouitora as universal us civilization to celebrate a 
OtU in iIm- lii torj of ft lie institution, by assembling 
»» friend i" • i In i in rtyoice with one another and unite in 
hill if |i" li luii fallen to my lot to-day to 

• I- tin Vf uclieal faculty of the University in the dedi- 

• ll II .ill, m 1 1« I in their name and behalf to otter 
' •».'! heart) w ' Iconic. 1 Conor to the govern- 
tl l III vol it \ , ami u rati tude to its benefactors, that 
m,i.i,.| 1 1 1 uxhibil to you a building so noble itt its 
iiimI complete in its appointments! I extend a 
oohllul woloome to the young gentlemen who have come 
n no ninny iiimI distant places to form our medical family. 
\l«»\ I uocced in animating them with a love for their 
tudlt . and courage and perseverance in pursuing them! 
I i • iii' hope i«» prevent them from wasting their time and 
'i >, 'i|, in mi ill-judged method of acquiring knowledge. 
I i Ion • i "if teaches medicine thebetteraequainteddoeshe 

I in w iili the inherent difficulties of the subject, and the 

i' 'l. rplv impressed with the grave responsibility which 

i • i up- ii il who teach and on those who learn it. I 

I. ill, Mi. rcfore, perhaps !>«• pardoned for the practical charac- 

• «•! ins di course, and for its barrenness of those rhetorical 
llowi i which might have seented more appropriate to a day 

• •I | il hi lee like l In- present. 

I b( lift) of man maj be measured by the years of a genera- 
i bj tic threescore years and ten which form the 
Ordll U ' 'in of longevity. Animal life is limited by 

laws, A lew years sooner, a few years later, it 

( lliallM Into tie* unknown, and the organism it informed 



returns to (lie dust out of which it was taken* Hut the life 
of nations, societies, and institutions has no fixed and deter- 
minate limits. It 1 1 1 ; i > be so ephemeral as to leave no trace 
upon tin' sands of j o>r it may live for centuries, and, 
gaining strength by increase of years, seem destined to im- 
mortality. The judicious student of history Is apt to dis- 
cover thai the longevity of institutions, like that of animal 

organisms, depends firs! of all upon their inherent vitality, 

the perfection of their structure, and the freedom and regu- 
larity Of its action, and theft upon the external eirc U in- 
stances to wliieli it stands pel a ted. Whatever nation or 
institution develops its natural powers by a diligent cultiva- 
tion of whatever will promote their growth tends to become 

strong and independent. It is not so much the form as the 
acts of its government that develop the resources of a nation 
or an institution. There have been tyrannical democracies 
and liheral monarchies ; wisdom has spoken from the agora 

as well as from the academy ; it has flourished under the 
tyranny of a Louis XIV. and perished under the brutal 

liberty of a French Republic. Those extreme cases justify 

what common observation demonstrates* that, US regards at 
least the nations of Ku rope and their descendants in America, 
progress and safety have, on the whole, been best secured by 
the very system which is employed in the most, perfect 
mechanical contrivances, a system in which springs and 
weights, power and resistance mutually restrict the action 
of one another. And what is true in mechanics and politics 
is equally true in every other sphere. Unfettered liberty 
rushes speedily into license, just as certainly as, on the other 
hand, despotism paralyzes action. In certain count ries of 
Europe in which the institutions of science and learning 
have for cent uries given hut little evidence of life either in ac- 
tivity or in fruit, it is easy to trace their intellect ual lethargy 
to political and ecclesiastical tyranny; and it is equally plain 
that in the freest nations, and especially in our own, an infinite 
amount of talent and labor is frittered away, and its results 
are shaken oil' like untimely fruit. Gonitis is often dwarfed 
in its growth for want of nurture and protection; often seems 
to have existed for no sufficient end, simply because it 



5 



i od the hand to support and guide it, as well as to guard 

1 1 i i mil pd harm. 

In whatever institution (lie forces which move it are 

uo-ordinated and balanced, the most perfect results are 
nbtttitied ; whenever they are wanting the results are apt to 
I" iin olutiON in council, unsteadiness of action, immaturity 
»•! production, and an ephemeral existence. It has been 
arfmimblj ;iitl thai the secret of free movement in the 
QnWa] 0 I equipoise." Kv>tv normal act in the physical 
ji 1 1* I in the vital domain, and not less in the moral world, is 
Mm i' nil of a balance of pow^fc The planets revolve around 
iIm imi in virtue of tin* counterpoise of gravity and the 

I fill i\ lorco; life, as Biob&l expressed it, is the sum of 
tlx powor* thai »«• isl death; the social system is the equili- 
brium twtweon barbarism and oivilizal i<>n. Just as certainly 
i ll l i-ii'i ) torn o I laws, the wisest administration 
i>| | ii b| 1 1 n llii 1 1 ,t)ie most efficient method of education — not 
I I in inn Icallj best, hut that which is in 

i ii--) Imnnoiij with the condition of the people where 

l thou Li * like these tho mind seems naturally led by 
1 uvoiil of this day, in which we are assembled to inaugu- 
rate 1 1" now building of the Medical Department of the 
I Itlvei Itj "l" Pennsylvania* Who that is acquainted with 
l)h humble lodging which first sheltered its ambitious 
I t. nl , could recognize in it the primal idea of the palace 
in which we are now assembled? Or who could discern in 

ili< let) moans at their command for illustration, the 

•< ihi "i Mi' 1 unrivalled museum and apparatus which now 
oomplote through the senses the education of the mind? Or 
who that does not know the brief duration of the lecture- 
tonu of those days, the scanty materials for instruction 
b i' then existed either in books or in the personal experi- 
ol the profe or , the really embryo condition of medi- 
■ <l i km..- ;ii (Imi time, C$31 realize that now in every 
Ii «>l medicine the teacher is absolutely encumbered by 

• I f the material he is obliged to prepare for his 

|>U|dl , .mi. I constantly forced to regret that the duration 
"I iIm QOUPieS has not been increased so as to Correspond 



witli the grander proportions of the building in which they 
arc delivered ? 

The successi ve changes which have led up to the present 
development < ► i* i he school hn ve been i » • > r 1 1 material and intel- 
lectual. The former Rrere more or less accidental 5 the latter 
were organic and normal, the legitimate result <>i a higher 

and wide? culture. It is well known how for years the 

Medical faculty panted for uiore breathing room, for wider 
space to hold and t<> display its treasures and for expert- 

mental research and teaching; and above all Inr a clinical 

institution in which it should be at home, and in which its 
own professors^ or others in complete harmony wit h them, 

should carry to the bedside the traditional doctrines and 
praef ice of the 1 1 ni versify. 

This longing has at last been satisfied. These objects, 
which for so long a time were regarded as remote possibili- 
ties. t<> he hoped for, worked ibr, prayed for, even, but 
hardly looked for, have now become realities. Yonder 
smiles the beautiful face of our hospital, offering health to 

I lie sick, soundness to the maimed, ami to all sufferers pro- 
tection and care; and here we arc assembled in an edifice 
whose equal in extent, in architectural statcliuess, and in 
adaptation (o its ohjects, does not exist among the medical 
schools of this country, nor even, 1 believe, in Kurope. By 
a singular chain of events the memorable translation of the 

[Jniversity t<> its present site was accomplished. The first 

link in the chain was the need of the [Jnited States of a site 

for the national public offices required in Philadelphia. The 

formation Of the Second link depended upon the success of 
the Board of Trustees in convincine; a government commis- 
sion that no place was so well fitted for the purpose as the 
old site of the Tniversity. That being determined favor- 
ably, the possibility of further progress depended upon 
the purchase From the city of this ground at a moderate 
price; -till later it depended upon the appropriation of a 
large sum of money by the Legislature of Pennsylvania, 
which, in its turn, was made contingent upon the subscrip- 
tion <>!' an equally large sum by private liberality. If any 



OW ol the link* in this chain of contingencies had heen 
l.i"! ■ n, the whole scheme must have ended disastrously. 

Hut not One <>f them was allowed to fail. Wise heads, 
Hhtl BOUragCOUS, earnest hearts were leagued together to 
render the project successful* The Board of Trustees, to 
whom the active inception of the matter, and all the legal 
and tlttmimstrative steps towards its completion, necessarily 
belonged, nmj well be proud to look upon tlie monument 
ih. \ have erected to their imperishable honor. The Provost, 
i . I. * Q and personal influence in legislative bodies 

0 much i due: The Professotfc in the Medical Department, 
n i whom labored with distinguished success in obtain- 
ing lli< inn. i for the erection and endowment of the hos- 

1 l il Tie 1 II- pital Profe or of Clinical Medicine, whose 

jtiilh i.mi , and devoted espousal of the cause of that 

In lltutl \t\th i li t in t<» pootil ia r honor: The Committee 

|Hd IllPfllbftl "i ih.- ooietj of the medical alumni, and 

till, within Mm- I nivursity ;is well as in the general 
( ■•I ! tiavt contributed by their wise counsel, their 

i l I a hot . atld their generous gifts, to carry this grand 

•••hie. forward to the completion which you this day wit- 

I' ■ and nil of them this public acknowledgment is 

ne. i in il\ due. Their ellorls have been successful and their 

ii n in mated, not only because they were earnest 

and dUigont, hut because they were made in behalf of an 
Institution whose long history warranted a belief in its 
p. in. in. uuy, and whoBe merits are attested by professional 
|$ld \( ntific achievements which there is no one to ques- 
tion, and because the public felt assured that the efforts 
in .-I. ! " b< half of OUf medical school were prompted by no 
.Ih h 01 narrow spirit, and that its gifts in land, or money, 
p| i.i i, «.r in whatever else, were sure to be wisely and 
Iioim ii\ administered. The) saw in this school the same 
• I. in< hi "f permanency which belong to the most stable of 
. irthlj in titutions; the geal of the faculty for an enlarged 
I curriculum, moderated and controlled by the 
tUtlon of the tXuivewity as well as by the condi- 
i ii,. medical profession generally; just as thoy might 
• •M 1 1 1 maj hereafter see. the conservatism of the 



8 



Faculty quickened by impulses proceeding from these very 

directions. And thus ii came about thai there was begot 
among the enlightened and at the Batne time serious and 
judicious classes of society, a firm faith in the vitality and 
durability of I be school. 

DP I have seemed to dwell upon the idee thai the Medical 
Department of the University owes its success and reputa- 
tion to a wise balance of the powers which control it, let me, 
I beg, be excused, since I am convinced by the history of the 
times we live iii, that t he great defect of political, educational) 

and even scientific movements in the present, day is — haste. 
The slow and deliberate progress of travellers in other days 

compared with the present light ning-li ke swiftness; of their 

movements, illustrates in many points a similar contrast in 
the intellectual world. In the last generation it "required a 
month to travel from Edinburgh to Naples, or from Boston 
to San Francisco, a journey which to-day is accomplished 
within a week. The end, to be sure, is reached ; but in what 
is the I ravel ler the bet ter of his exploit, in what is he different 
for it, except by the exhaustion of his laborious and exciting 
journey ? What knowledge has he acquired of the lands he 
has traversed ! of their geographical and geological features, 
of their monuments of human enterprise, of their inhabitants, 
and their history, their customs, t heir intellect ual and moral 
peculiarities? Nothing, or next to nothing; above all no- 
thing exact and trustworthy, [f the passion for rapid pro- 
gress were confined to travelling, the evil would be compara- 
tively small, since the traveller may repeat his journey again 
and again, and tarry wherever he will, and as long as it 
pleases him. l>ut, my friends, the journey of life is made 
but once, and whoever has failed to make it aright has failed 
forever. 

In every department of the busy world haste appears to be 

the rule. All are hurrying towards a goal, too often without 
regard to the means employed in reaching it. Everywhere 
metl are making haste to be rich, and t hey st niggle on through 
bogs and briers, and dark ways, and stony places, and if they 
d«> not peri b by the way, perhaps at last embrace their golden 
idol. 0? perhaps t hey are ambitious of social, professional, 



9 



of political distinction without the qualities that fit them 
for it or t he virtues that deserve it, and they will u stoop to 
anything that's base," and harter honor, and even self- respect 
to obtain places for which they are unfit, and would be 
unw orthy to fill. 

I am no eulogist of the " good old times" because they arc 
old, but because in many things they were good, and in none 
more so that] in acting upon the inexorable law of nature, 
Ehlbt all permanent things are slow in reaching their maturity , 
and that all rapid organic developments are feeble and short- 
lived in proportion to the rapidity of their growth. Strength 
in ;i complex structure depends upon the strength of its coni- 
pMh,>iit parte, and if these are weak, and loosely put together, 
th<a building, the monument, the plant, the animal, or the 
mind will be proportionately feeble, and liable to destruction 
under the first h ;iitM>r storm. It never has been and never 
will be tbal mind hastily stuffed and overladen with 
knowledge will profit by it to grow in stature and strength. 
[£ ii it not crushed at once into imbecility, it may perhaps 
Bash into a precocious brilliancy, which will be followed by 
:m endless night of star-lit mediocrity. 

Now, gentlemen, you have come together here to be made 
physicians, and I entreat you let us have a clear understand- 
ing ot what can and what cannot be accomplished. To make 
physicians by conferring a diploma upon you after the 
usual examination is a duty which we shall be very happy to 
perform ; but it will not rest with us alone to make you 
deserve that distinction. The more sagacious and thoughtful 
of those who receive it know best of all how unfit they are to 
perform tin* duties of medical practitioners, and even when 
rience has made them familiar with these duties, they 
• •nov rvrry ve;tr less absolute in anticipating favorable re- 
nd > and less confident in the efficacy of art as distinguished 
to 'in nature* Will yon allow me then to endeavor to present 
to you Home notion of the place which medicine appears to 
M the field of knowledge, the limits of its power, 
Md the attractions which it possesses for the liberally culti- 
itod mi lid. 

i sj profi iou or pursuit in which a man is long trained, 



10 



not only leaves its impress upon bis mind, I » u f more or less 
moulds it ina peculiar form. Tin* mor^exclusively it is cul- 
tivated the root© visible does its power become. So gene- 
rally is this 1 1* 1 1 1 It recognized thM a shrewd obeerver will 
often be able to decide upon the occupation of a man from 
bis bearing in society, and the manner as distinguished from 
the matter of his conversation. The dogmatic style o( the 
theologian looking always to an infallible authority; the 

clear, well-arranged ideas of the jurist , who also is governed 

hy authority, founded perhaps in nature, but artificial in 
form : the tnathemat ician shut ina si ill narrower field hedged 
by abstracl ideas; the study of all these when exclusively 

pursued tends to narrow the mind and dry the heart. Even 

the pure chemist, dealing only with the physical relations of 

atoms, their attractions, repulsions, combinations, and de- 
compositions, regards as the highest expression of his science 
an algebraical formula which is abstract and lifeless. There 
is no human side to his science, and therefore, however it 
may enlighten the understanding, it leaves the moral senti- 
ments uncultivated. But the charm of medical studies is 
that their tendency is the very opposite of this. They include 
the most varied and dissimilar elements, st retching from the 

abstract and impersonal on the one side, to the opposite and 

material limits of the field jbf knowledge ; for the physician 
has to deal with the living body and the immortal soul, with 
the physical heart and the moral heart. Along this vast 
range there is hardly a science which he may not invite into 
the service <>f humanity j hardly an art which he may not 
make subservient tO the health and happiness of mankind ; 
hardly a branch of knowledge which he may not compel to 

be his help-mate in the prevent ion or the cure of disease. He 

cannot constantly watch the reactions of soul and body, as 

he alone is able to, without being impelled to st udy the great 

questions that lie at the foundation of human belief. He 
cannot witness the amazing uniformity in the relations of 
cause and effect without embracing the fundamental ideas 
Of all legislation, human and divine. With the mathema- 
tician he can calculate the forces which man exhibits as a 
living machine, and with the chemist study the generation 



11 



of tho g forces by the conversion of dead mutter into living 
1 1 ik. This and vastly more it is the tendency of medical 
hid 1*1 t$ do; it is all implicitly included in them, and of no 

• •Hi. i ; i ;ui the same he so truly said. If the physician often 
fail to attain the height which these statements imply, the 
htllt, OVCtl in the case of the most gifted and zealous, is in 
In Unite powers, the shortness of life, and the thousand 
human cares which harass his career. But none the less has 
hr.i field to explore iticomparabtytyider and more varied and 
Interesting than ties before any other searcher after knowl- 
edge, and o far :is he can become acquainted with it will he 
And his own happiness increase atod his power of doing good. 

h need pot be concealed thai this knowledge is inexact 

in the precise proportion "I" its vastness. Medical science 

possesses no creed contained in ;i few sentences, nor strictly 
defined [>ri tioipK like law r nor a short list of axioms and 
p.. titlat( like mathematics, Such philosophical conciseness 

OBJlllOl bo Used In describing Che phenomena of organic 

nattirj Life manifestations arCf indeed, hedged in by ex- 
rne limits which cannot !><• transgressed. A striking 
p. . uliarltj «»t living beings is the unlikeness of individuals, 
tn- i in' i wo of them, whether leaves, or Howers, or features, 

• M organ , or the functions, whether mental, moral, or physi- 
cal, or the diseases which derange these organs and functions, 

h. evei Identical with one another. It is this unlikeness, 
d.i variety, that imparts to animated nature its highest 
ehnrui. We admire and love it instinctively, while sameness 
of form and condition affect U8 with weariness, like monotony 
Oi OUnd. It almost seems as if this aversion to uniformity 

were Implanted in us for the very purpose of stimulating us 

i. . Sarcfa oi.l team forever, thai we might stretch forward 
i i i pall knowledge in the world, and even beyond it in 
ill. world to come. The contemplation of nature discloses 
tto SttOh RIOnOtOtiy J it docs not exist in medicine, which 
. n.i-i i - o largo a portion of her realm. The physician 
IIMJ * l • |4H knowledge from every field. He discerns health 
or sickllOSS In the sunshine and the shade; in the winds 
'l.ii t o tth< po tilence, or thai come with healing under 
tlieil MflQgS I' ' be thai tells us which are the waters that 



12 



restore the sick, ami which distil poisonous vapors; lie that 
distinguishes the wbolesotbe from the noxious plant; that 
discovers the virtues that lie hidden in the mineral, and 
extracts from it and from organic products the weapons 

with which he banishes suffering and 1 riuinphs over death. 

It is the physician whose investigations reveal) the marvels of 

the animal Structure, amazing even when it lies lifeless 

before him, putting to shame the utmost ingenuity of human 

mechanism ; it is he who displays if in action, at every step 

ami in every act of life performing miracles, converting bread 
ami wafer into flesh and blood, and making of the air we 

hreathe a consuming lire; it is he that by the skill whieh 
science gives him renders sale the often perilous voyage of 
the infant to the, light < >f day, ami guards the tender st ranger 
from the earliest dangers of life. And what shall I say of 
the almost infinite Held whieh is the province of medicine 
and surgery ? of the science of disease as it reveals itself in 
the changes of function and structure? which treats of the 
Wreck and ravages that disease leaves behind it, and whieh 
tenders intelligible the causes of the catastrophe? of the 
voice., of the suffering organs which, though inarticulate, 
are none the less significant to the skilful ear? of the visihle 
deform it ies, distort ions, displacements, and mutilations 
which, as well as diseases, mar the symmetry aud hinder 
the u<es of the body? Or shall 1 speak of the physician no 
tpnger 09II naturalist or a pathologist*, but as a man, whose 
moral, not less t hau his intellect ual nature, must he exercised 
in his calling ! What are drugs ami what are ingenious 
m trmiients hut so many material agents, essential, perhaps, 
tor t lie eure of t li<- sick ; hut what is t heir power, when used 
alone, compared with that they display when vivified and 
potent ializcd hy the spirit, of humanity guiding a keen in- 
sight into tin' secret places of the heart ? Hope is often no 
Less enlivening than the most stimulating elixir ; sympathy 
no lees SOOthing than the gentlest anodyne; counsel no less 
Strengthening than the most, powerful tonic; and often 
nature, sustained aud cheered hy these moral influences, 
triumphs over obstacles which no mere medicinal assistance 
would have enabled her to surmount. 



\ s tllOfOf then, anything the physician need lack to realize 
all thfl QOIIOeptions <>f his understanding, and to satisfy all 
thi • mi, m". of his heart ? Surely, nothing. It, therefore, 

bol vei ovory one who is preparing for the life of a 

| Im |< Ian 1 1 * feel, at every step of his progress, how vast a 
Hi Id i 'i knowledge helms undertaken to explore, how rich 
<»ml rnried are its prod nets, and how exalted is the mission 

tO wlneh he is <|esl ined. 

In the remarks Ihat have I >een made respecting the rela- 
tion of science and art in medicine, I was, perhaps, less 
oxplieil than was proper, for upon a right apprehension of 
the < relations must depend in a great measure the fruitful- 

Ul "l VOOr professional Studies, and the solid merit of your 

oareei < practitioners, Let mo endeavor briefly to state the 
in. -1 1 1 1 iv clearly* 

Xo OM who 1 o" 1 pOtit «•!•! with the simple observation of 
lllll uek tO I- no their Causes and mutual relations, it 
• i in i i dark problem how science and art shall be 
mi . i- to liartnonta with oue another, lie knows that per- 
root Ion hi one should correspond to perfection in the 
othei inoi both are essentially hut different modes of the 
mm- truth; 1 1 1 ; 1 1 science should he prepared to explain the 
phenomena produced or observed by art, and that art, in 
like Manner, should bo competent to reduce into practice 
all the conclusions of science. It would, indeed, be so if 
leieiililic laws were absolute, and if the power of art to 
execute were perfect But science in the abstract deals only 
with abstract ideas, and lis laws are absolute only so long 
.< ih« •;. relate tO such ideas. The substance, form, bulk, and 
Other qualities of bodies in science are abstract notions, not 
OOnoret* faets. The genus Or species of the naturalist has 
UO pteci e limitation in nature; nor has any simple sub- 
stance, SO railed, nor any compound body, the precise con- 
itttutlon which in Bcience it is assumed to possess. Thus in 
i tatemenl or argument into which such elements 
Outer, Allowance must be made for departures from the 
theoretical tdna of them. These statements suffice to ill us- 

n. ii- the general proposition that every applied science is at 
Ih i I. hi ;. . inirc (»f approximations ; that absolute truth in 



14 



it is Impossible, and, therefore, thai the which corre- 
sponds to such science must p088es$ not Ottly itfl own inherent 
imperfections, but those also which belong to the science 

which illustrates and explains it. 

But if even in I he exact physical sciences laws are never 
absolute, how infinitely lesss.. must those be which govern 
living beings even in their physical conditions and relations, 

to s;i\ nothing of those which regulate their mental and 
moral existence. The laws of this domain readily elude our 
Intellectual grasp; its problems cannot he precisely ( le lined ; 

within it we are compelled to accept conclusions which can* 

not he explained, and act under the guidance of experience 
more than under the control of law. So Ear ;is medicine is 
really a science it does not solicit but commands our belief. 
It does not permit us to hold opinions about the constitution 
of the body, nor about the mechanical elements of the various 
func t ions, either in healt h or disease. On the other hand, it 
leaves us free to adopt whatever judgment reason dictates re- 
garding the cure of diseases. In this department absolute 
demonstration is impossible, since the physical events in dis- 
ease arc being perpetually modified by a thousand influences 
which ad through the minds of the sick. And, just as we 

ha\ <* represented science as commanding assent, so musl we 

Speak of faith as 80Ketting belief. And yet, as the sunshine 

in the fablecajoied the traveller of his cloak which the storm 
could not wrest from him, so faith will often exorcise the 
demon of disease which science bad vainly endeavored to cast 
out. 

To determine the limits which should sepa rate science and 

art is, perhaps, impossihle, since t he one grows out of t he other. 
Science is the producl of ait as the crystal ia formed in the 

liquid thai holds its substance in solut ion. Every physician, 
however humble his attainments, performs it scientific act 
whenever he compares together the facts of his experience ; 
and he who by generalising a multitude of facts lays the 
foundation of a system really does no more. In this process 
win. shall say where art ends and science begins? In truth 
it is Only a question of degree. In the wards of a hospital 
where I he instruction 18 confined to t he elucidation of indi- 
vidual cases, H is just as scientific as in the didactic lectures 



is 



in which the attempt is made td present, in a single view, the 
n 'ili .'l Innumerable cases of the same kind in every 

• IvlHxod country , and al ©very epoch of medical history. Yet 
w • i. clinica] medicine as illustrating art, and didactic 
mod lei no ;i representing Bcience. What figure, think you, 

lid ' In- hospital professor make who should come before 

you with ;i patient, a.nd be itnabl&to determine with what 

i| the (icrson was suffering} the organs aftected by 

1 1 Ihi nature of tboir functional disturbance, why some 
I'll tic t int in rather than others were disordered, how these 
tnoul ; affect the issue of the attack, what that 
i IK will probably l><\ and finally:, what means should be 

hi mi to U»i ll favorable? Vou might be unconscious that 

i in | 1 1. , 1 1. ,i, ol In touching WS* owing to his ignorance 
f H I 1 1 ' iK Ihi) n • hi would feel very sun- that it was 

• • 1 1 1 • 1 1 * • t mill m m • • 1 1 i u i « • » \ i h perhaps you would know 

I ' i i 1 I I h i hi Mm Ip'IiI i»f srinil ilie generalization 

; ly ol ' t lid case, and you would t urn 

istrtH'tl ii nil had " iiiH-d iii didactic lectures upon 
|| itltjiwt, and In which all of these relations of the 

i »M\ eon idored, illustrated, and explained. 

In mi Ihi word , vou would endeavor to learn the science of 
I Ik* Miihjrrl. Having mastered that, you would feel that 

v\i.. tin i the in i example you encountered of that particular 

i i wore more or less like the one submitted by your 
U u In i yaw would be able to recognize its nature, anticipate 

ii • in Q, and confidently attempt its treatment. You would 
Si 0 feel that ftcicnce Lifted you agOil a height from which 
yOU Oould ui\« \ the whole pathoipgieal field, and gain clear 

Mid accurate Mean anobscured by the details, and the special 

. |f< ii mi tllUCCfl of the individual case* 

mi ih. \ i. \\ , then, are really practical views expanded. 

I - I ii 1 1 ighly practical in its best sense is to be most 

niili. •; to be most highly scientific is to be most 
|wrftwtlj practical. But, you will say, scientific men are 
oldom pmctical, and practical men iire not usually trained 

i mill. methods* To which [ answer the greatest men 

.m. both St j 0*011 Of fl somewhat lower rank are able 

to embrace the absthlCt element^ of science only, feeling 



16 



repelled by the often wearisome details of observation; in a 
lower stratum still are they who concern themselves about 
details alone* and work out from these more or less empirical 
roles w liieh serve t hem instead of principles; while the hum- 
blest grade of nil consists ol* men bill little apt to generalize 
or iva.-Mti, and whose chief aim is t<> learn t'roni scanty com- 
pends what is w good" in this or the other disease. 

The history of medicine is marked by successive periods 
in which empirical and scientific methods have by turns 
prevailed, and a study of them both must Satisfy impar- 
tial inquirers that neither can be relied upon exclusively 

t<> establish principles or to found a method of practice. 

Of the two the empirical is unquestionably the most fruit- 
ful in lasting results; and the successive pise and fall of sys- 
tems opposed to one another proves that a trust in them as. 
an end, and not as a means, is delusive. Such a delusion in 
regard to an analogous subject is attributed to the famous 
Metternieh, who for so jbng a time controlled the politi- 
cal condition and relations of European States. He is re- 
ported to have said : " I believe that the science of govern- 
ment might be reduced to principles as certain as those of 
chemistry, if men instead of theorizing would only take the 

trouble to observe the uniform results of similar com hi nations 
of circumstances." {Loiui. Quar. AVr\,.IuIy, 1*7:?.) Hut pre- 
cisely similar combinations of circumstances in the political, 
as well as in the medical world, are never reproduced, and 
hence the successive results of observal ion are never identi- 
cal, and the laws which they are used to construct, can never 
be applied without modification to individual cases. To 
w hat extent they must be modified depends upon the indi- 
vidual who applies them. His natural genius ami his ac- 
quired skill may make all the difference between their suc- 
e&fe and their failure in his hands; and hence the same 
method may produce brilliant results, or altogether fail, 
according to the skill which directs its application. This 
nkill belongs to the individual, he eannot communicate it to 
Others, and when he dies it perishes, In this view of the 
inbjecl the influence of the individual, whether teaching 
Or&llj Or by example merely, can hardly be over-estimated, 



17 

i I tlx " fere it' is of the highest importance that lie should 
h in lUi beginning to the end of his pupilage he so educated 
i ii 1 1 < ■ a proper method as we3 1 ae the hahit of research, 
i.« enabled and incited to pursue his studies through- 
out [ill professional career. 

Phi doctrines I have endeavored to illustrate are simply 
h an I have many times (kin hied, hut there seemed to be 
11 peculiar obligation to take advantage of this occasion to 
enforce them anew. For now it is that the friends of the 
University are warmed by the memory of its past distinc- 
tion, the spectacle of its inauguration in this new edifice, and 
the hope that it will not. Ion - delay to put in practice a 
system of instruction which i demanded by the example of 
all foreign and even of some American colleges, and therefore 
by a regard for its honor an the oldest medical school in 
the United States. This \\o\m li no Longer vague and un- 
founded; it begins to assume liape and consistence, and to 
show that it rests upon I he tun. conviction of ;i large num- 
ber of physicians who ;m. ,n \g the most accomplished, 

earnest, and efficient KOpportQfl , not of this school alone, but 
of the still higher school of universal American medicine. 
They know, and ev< i\ \« .u fchej perceive more clearly, that 
the sphere of mcdn n.« i rapidly enlarging, and that an 
attempt to restricl it tudy within the old-fashioned term is 
not only impoi ibl< but absurd. Tiny know equally well that 
the established Imp bft&ard fu hion of studying it, without 
systematic development and subordination of parts, defeats 
the very objects Oi it * study, and tends to discourage feeble 
students and disgust the well-educated. They know that 
medical proUudoi h without honojr themselves, are filching 
honor and health (Vona their deluded victims. They know 
that iii m. dioinO] M in Other professions, there is a tendency 

to cut I frotfl 'lie principles which have hitherto saved 

the I tat faM anarchy, and society from dissolution ; that 
evet 1 ' * i * i presumes to pronounce judicially upon sub- 
ject b( ' • i acquainted with, and that in the midst of this 
cbac i - Mid. opinions, this clamorous tumult of the igno- 
ranl Hi- in, and presumpi nous, the most precious fruits 
ot I, hi... mi wnujoin, and the very foundations of human faith, 
•J 



is 



are threatened with destruction. From sucli a catastrophe 
the only salvation is in more thorough knowledge, whereby 

truth shall he upheld, and error crashed beneath its feet. In 

our own profession lei us feel very sun* that error and fraud 

are not to be put down l>y the keenest satire or by the most 

violent invective ; on the contrary, it is their nat uretO thrive 
upon whatever brings them more into the light of day, even 
though it be to set them in the pillory of public contempt. 
Cie1 thein gO Bbeir ways; but let us endeavor so to r\alt our 

own profession by iniprov&g it, that they who may hereafter 
bear the name of physician shall by that v. i v title be recog- 
nize! as being thoroughly educated ; learned that they may 
know w hat, has beet] done before them, solidly grounded also 
in the BCienee Of mediciniL before attempting to build upon 
il the superstructure of mejlical art, and so enriched bj knowl- 
edge, that when they go out into the world they may feel 
assured of securing the Confidence of society in themselves, 
and in the art which they practise, 

I have spoken of j >rofessiona I aims and duties, but it must 
not be forgotten that physicians are also men, and that there 
is something more to be regarded than the success which 
maj be measured by intluenee, reputation, Or even wealth. 

How couch soever of these it may confer, yet, if they do not 

teiid to give us happiness, of what value are they? There- 
fore, let it be understood that the culture of knowledge for 
its own hake, and quite independently of any material re- 
ward that it may bring, is in itself a happiness so pure and 
90 bigb that, it may well be doubted if there is any richer 
source of pleasure upon earth. And it is peculiar in this — 
it is a pleasure that never fails. The appetite may be 
Satiated) the passions may be consumed in their own lire, 
but. the love of knowledge is an appetite which grows by 
what it feeds <>n, and a passion that, burns forever. It seems 
to be the only faculty of the human intellect, as distinguished 
from the human heart, which faith and reason unite in 
assuring us must be immortal. Whatever, therefore, may 
be your material fortune in after life, as a consequence of 
rightly pursuing your studies here, whether eminent or 
humble in your professional rank, be very sure that you will 



10 



have seeured a talisman against despair, or even discontent, 
in the love of knowledge that your education will have 

.'iv.'ll YOU. 

I have in th is discourse held before you, as motives for 
ar(|uiring a thorough professional education, the love of 
knowledge, and the happiness it confers; but it must not 
be forgotten that a still higher motive is to be found in the 
benefits it. will enable you to eonfer upon your fellow men. 
This is, indeed, the very reason why the profession of medi- 
cine exists. Health is one essential condition of human hap- 
pineSS, for all possessions lose half their value if the ability 
to enjoy them is wanting. But it is life, as well as health, 
thai will be entrusted to your keeping; lite, with its hopes 
and plant) Its loves and friendships, its duties and responsi- 
bilities) thai will often depend bpon your knowledge and 

kill, and tht an Q which you may here acquire of the 
• I* rtltj --I pouf office It your time is misspent in idleness 
and rrlvolity f oi In parading a folse method of studyv ycuxr 
aftcu llf< will oein to you a perpetual mistake, will be a life 
ol failure, porhap mingled with Belf-reproach, and possibly 
of dingraee. (Jul if you now devote yourselves to the 
Requisition of pmfrs>iona! knowledge, energetically and 

\ ^mal ieally, yon will he secure of public confidence and 
professional esteem ; and whether you are destined to be 
eminent leaders in medicine, i>r merely honorable members 
of the profession, you will enjoy that reward which is 
independent of fame and wealth — the consciousness of 
having done your duty.